Incidence and outcomes of intraocular lens exchanges in patients dissatisfied with multifocal lenses: 15-year retrospective dataset analysis.

Abstract

Purpose: To assess the incidence, clinical outcomes, and adverse event rates of intraocular lens (IOL) exchange in patients dissatisfied with presbyopia-correcting multifocal IOLs.

Setting: Private clinics, United Kingdom.

Design: Retrospective study.

Methods: Data of patients who underwent multifocal IOL implantation between 2007 and 2021 and required the exchange of IOLs due to quality of vision issues or insufficient near vision were reviewed. IOL exchanges for other reasons (dislocation, opacification, or other adverse events) were not included in the analysis. Visual and refractive outcomes of the lens exchange procedure were analyzed for the last available follow-up.

Results: The mean time from the primary procedure to the IOL exchange was 13.6 ± 8.3 months. The total IOL exchange rate was 0.63% (688 of 109 274 lenses). Of these, 637 exchanges (0.58%) were performed because of quality of vision issues, and 51 (0.05%) were exchanged primarily because of insufficient near vision (eg, IOL with lower near addition exchanged for an IOL with stronger near addition). Post-IOL exchange, 71.7% (493/688) and 91.3% (628/688) were within 0.50 diopter (D) and 1.00 D of emmetropia, respectively. The mean postexchange uncorrected distance visual acuity was 0.11 ± 0.21 logMAR (20/25 -0.5 ). The anatomical position of the secondary IOL was as follows: in-the-bag fixation 86.8% (597/688), ciliary sulcus fixation 12.5% (86/688), and alternative fixation (iris claw, scleral fixation, or IOL suturing) in 0.7% of cases (5/688).

Conclusions: Patients requiring an IOL exchange due to dissatisfaction with multifocal lenses achieved favorable refractive and visual outcomes. In-the-bag implantation of secondary IOL was possible in most cases.